Healthcare Provider Details

I. General information

NPI: 1679335228
Provider Name (Legal Business Name): SAMUEL VELTRE NBHWC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 REGENT ST
HOUSTON PA
15342-1231
US

IV. Provider business mailing address

723 REGENT ST
HOUSTON PA
15342-1231
US

V. Phone/Fax

Practice location:
  • Phone: 724-833-1958
  • Fax:
Mailing address:
  • Phone: 724-833-1958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3816797
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: